COMMENTARY

Resilience and Burnout in Family Medicine

María Colón-Gonzalez, MD; Kim K. Yu, MD

Disclosures

September 01, 2017

Editorial Collaboration

Medscape &

Editor's Note: This discussion is based on a presentation given at the American Academy of Family Physicians National Conference of Family Medicine Residents and Medical Students.

Kim K. Yu, MD: Hi. My name is Kim Yu and I am immediate past chair of the Michigan Academy of Family Physicians. I am currently working for CEP America as a director of quality and practice for 25 of their urgent care centers throughout the country.

Maria C. Colón-Gonzalez, MD: My name is Maria Colón-Gonzalez. I'm a family physician in Texas and I work with both family medicine residents and medical students. Today we are here to talk about resilience.

Qualities of Resilience

Dr Yu: We sure are. We know that it's a big issue. Many docs are suffering from burnout. The statistics say that over 50% of family physicians have burnout.[1] We know that building skills and resilience can not only improve feelings of job satisfaction but also improve how people work.

Dr Colón-Gonzalez: Also, it improves quality of patient care and safety. Tell me, Kim, what have you learned about resilience throughout your 10-plus years in family medicine?

Be Focused, Be Protected

Dr Yu: I really need to spend time to focus in on those things that matter to me. What did I really want to do with my life? Was it advocacy work? Was it the work I was doing in urgent care? I really needed to focus in on what was important to me.

Dr Colón-Gonzalez: Studies have demonstrated that it is essential for us to align our passions and values with our job. It is so important that we work in an environment where we can thrive and that is aligned with who we are. Sometimes we focus so much on being the perfect doctor. But it's not about the kind of doctor that I want to be; it's more about the person I am.

How would you tell a medical student to stay focused? Nobody in medical school ever told me that staying focused was going to be so hard. Nobody tells you when you are in medical school that you need to take care of yourself because, as a physician, you are at risk of mental health issues and suicide.

Dr Yu: I personally have known two physicians who committed suicide, and it was a devastating loss—not only for those of us who were their friends, but also for their families and their communities. It's terrible. We need to have things in place from an organizational standpoint. There need to be steps taken in each different organization and medical school to help protect students. Are we taking those steps? Anyone in a position—teacher, faculty, dean—is able to take care of students. Even the students themselves. Are they able to advocate for themselves? We need to put things in place to protect our students and residents.

Know When to Rest, When to Say No

Dr Colón-Gonzalez: I have learned by working with medical students and residents that sometimes we need to let people know that it is okay to just say, "I need a break."

Dr Yu: Sometimes you have to say no. We are trained to do everything, to be everything. To be the first person on the ward, the last person to leave—and to do all of this whether or not we eat, sleep, or go to the restroom. It can be an issue to take the steps for self-care and to say no to certain things.

Dr Colón-Gonzalez: Besides saying no, what are boundaries that you have for yourself? At what time are you just going to disconnect from the emails from work?

Dr Yu: We have to figure out different ways to really realign with our mission in life and the things and values that we hold dear to ourselves.

[M]edicine still has not gotten it. Wellness of healthcare providers should be more important than how to make them more productive.

Dr Colón-Gonzalez: In a conversation we had with all of the trainees at the conference yesterday, somebody mentioned how medicine still has not gotten it. Wellness of healthcare providers should be more important than how to make them more productive. The focus is often on ways that providers can see more patients—how they can be faster and more efficient.

Dr Yu: Studies[2] show that if you protect your physicians, help them build resilience, and keep them happy, they are actually more productive. They see more patients, patient satisfaction scores are better, and you have less turnover. It can cost an organization hundreds of thousands of dollars to find and recruit another physician.

Dr Colón-Gonzalez: Yes, that's true. The more that hospital administrators, deans of medical schools, program directors, and chairs[3] get involved—change can also happen from the top.

Dr Yu: We have talked about different steps that people can take, and there are some wonderful resources that are available from the academy and different organizations. The American Medical Association has STEPS Forward. What are things that people can do?

Take Time Out, Renew Yourself

Dr Colón-Gonzalez: It's important to focus on our passions, our values. Who am I? What do I really enjoy and love about family medicine? The beauty of family medicine is that we can do so many things. Take into consideration your clinical skills and knowledge. Do you have leadership qualities? Do you like administration? Are you good at writing? Are you good at public speaking and communication?

Then we talk about renewing ourselves. For every person it's going to be different. It could be taking some time to read your favorite book. It could be taking time to connect with family members and friends you haven't seen in a long time.

Dr Yu: What do you tell people who say, "I don't have time to take an hour out"?

Dr Colón-Gonzalez: It's about doing small things. If you are in the hospital, take a 10- or 15-minute break and go outside. Take a walk around the hospital and connect with nature.

Lean on Your Support Network

Dr Yu: The third step to talk about is how important support is. When I was going through all of the different things with my father passing, my support came from family and immediate friends.

Dr Colón-Gonzalez: Support is really essential. Support you get from family members, and friends make you feel loved and valued. There is also the very important support you can get from your colleagues, such as being debriefed after a challenging experience with one of your patients.

Dr Yu: It's important to be able to speak out and tell others if you are suffering from burnout or if you need help.

Dr Colón-Gonzalez: Speak out for yourself and also for your colleagues. You know family medicine; we are a family so we should take care of each other.

Dr Yu: In closing, we just wanted to say that you, the family physicians of America, are awesome. It's not a job title—it's who you are. Thank you for doing what you do every day.

Follow Maria Colón-Gonzalez and Kim Yu on Twitter.

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